Preeclampsia is a syndrome with exaggeration of physiological systemic inflammation of pregnancy. Placenta seems to be the initial stimulus for activation of systemic inflammation. However, the presence of pre-pregnancy chronic inflammation is also a determining factor. This could explain why women with pre-existing hypertension, insulin resistance and increased body-mass index have increased risks of preeclampsia and vice versa. Investigations on limiting the inflammatory response by treating maternal infections or novel anti-inflammatory interventions to reduce the incidence or severity of preeclampsia are warranted.